Ischaemia-induced vascular vulnerability resulting in intracerebral haemorrhage with ipsilateral internal carotid artery occlusion.
Intracerebral haemorrhage accompanied with cervical internal carotid artery (ICA) occlusion on the same side without moyamoya-like vessels is rare. A 73-year-old man with left ICA occlusion and no presence of moyamoya disease criteria underwent xenon-enhanced computed tomography with acetazolamide challenge test. The findings showed hypoperfusion and no vasoreactivity in the territory of the left middle cerebral artery. During follow-up he suffered bleeding in the left frontoparietal lobe. Cerebral angiography showed left ICA occlusion and cross flow via the anterior communicating artery without moyamoya vessels. Long-term ischaemia would make perforating or anastomotic arteries vulnerable. These arteries were easily ruptured by hypertension, resulting in intracerebral haemorrhage.
Furuse
Motomasa
M
Department of Neurosurgery, Kitano Hospital, The Tazuke Kofukai Medical Research Institute, 2-4-20 Ohgimachi, Kita-ku, Osaka, Japan. Mfuruse@aol.com
Shinichi
Wakabayashi
W
Suyama
Yoshio
Y
Takahashi
Kenkichi
K
Kajikawa
Hiroshi
H
D000368:Aged; D002340:Carotid Artery Diseases / Q000150:complications* / Q000175:diagnosis; D002533:Cerebral Angiography; D002543:Cerebral Hemorrhage / Q000150:complications* / Q000175:diagnosis; D007839:Functional Laterality; D006801:Humans; D007511:Ischemia / Q000150:complications* / Q000175:diagnosis; D008297:Male; D014057:Tomography, X-Ray Computed